W-DARE Blog – The PAG intervention – taking participatory action on sexual and reproductive health (SRH) for women with disability – Ligao, 8th of July 2015

Today’s post is written by Alex Devine, a W-DARE Co-investigator from the University of Melbourne. Alex writes about her recent trip to the Philippines in July 2015, working with the W-DARE PAG Coordinator, Ms Rak Ignacio, to support the PAG interventions. 

We are just over half way through the W-DARE Participatory Action Group (PAG) intervention. So it has been a timely opportunity to visit Quezon City and Ligao City and see what an incredible job the PAG facilitators have been doing. Together with the local W-DARE team, the facilitators have been working with each of the groups to improve knowledge and access to sexual and reproductive health (SRH) for women with disability. The PAG intervention has involved the development of six different peer facilitated groups of women with disability and a parent group, coming together every two weeks to learn about topics related to disability and SRH. Topics to date have included ‘what is disability’, ‘the rights of people with disability’, ‘what is SRH’, ‘family planning’, and ‘HIV and other STIs’. Future topics will explore ‘prevention of violence’, ‘positive futures’ and ‘developing action plans to improve access to SRH’. It is hoped the final sessions will help the groups promote and sustain individual or collective action on promoting SRH for women with disability. Each group has really taken ownership of the process and individualized the sessions to reflect the context and experiences of the women in their groups.

As I write, we are sitting in on session six focusing on ‘HIV and other STIs’ of the Ligao City PAGs – Team Tibay at Lakas ng Kababaihan (inner strength of women), Team Sisters, and Team Happy.  Each session usually starts with the facilitators conducting an ice-breaker activity, and then a warm-up activity to help the women learn more about themselves and each other. The groups then re-cap what they have learnt in the previous sessions through a creative activity developed by the facilitators.

The Ligao City PAG facilitators; Celinia Tayoyo, Juliet Llorin and Joy Bien, with the W-DARE PAG Coordinator, Rak Ignacio

The Ligao City PAG facilitators; Celinia Tayoyo, Juliet Llorin and Joy Bien, with the W-DARE PAG Coordinator, Rak Ignacio

For session six, the PAGs have been supported by a resource person with expertise in HIV, STI’s and sexual health. In Quezon City, the group for women with vision impairment (aka Sexy Warriors) and the group for women who are Deaf or hard of hearing, went to the office of W-DARE partners, the Likhaan Center for Women’s Health. At Likhaan, Arnold Vega and his team facilitated a very interactive and informative session for the groups. In Ligao, Dr Jose Relacion and his colleague from the City Health Office were well received by the PAG participants who were very grateful for all the knowledge gained through the presentations.

A participant with a visual impairment from Quezon City reads a braille translation of a resource on HIV and AIDS in Session 6.

A participant with a visual impairment from Quezon City reads a braille translation of a resource on HIV and AIDS in Session 6.

Spending time with the PAG facilitators and the broader W-DARE team has allowed us all to reflect on the PAG process to date. On talking with the facilitators, it has been great to hear about what has been working well, and what have been some of the more challenging aspects of the process. The women have clearly valued the support of the W-DARE PAG Coordinator Ms Rak Ignacio. Rak has been mentoring the facilitators around the content of the sessions, but also supporting them in their challenging roles as facilitators. Also providing invaluable support to the PAG process are Judith Marbella-Wanasen and Jezabel De Mesa in Ligao, and Mona Pindog, Cathy Dacillo-Domingo and Lyndia Navarro at De La Salle, as well as the broader W-DARE team. Let’s not forget Rocky Mahilum and his role in logistics, and Lai Salcedo, the president of the PWD Ligao Disabled Persons Organisation and chef de cuisine of Ligao!

The PAG process is not without its challenges. For some of the facilitators, this is their first time facilitating a group, and this has required them to overcome shyness and anxiety of presenting in front of a group, with really very little training or time for preparation before the PAG process began. Although watching them today, it is clear they have evolved confidently and engagingly into their roles. Whilst the women in each group have disability in common, or for the parent group, a child with disability; individual experience of disability is incredibly diverse and is layered with a person’s other life experiences and background. Bridging these differences and helping each group to develop common understanding amongst participants and nurture social connectedness between the women, has often required facilitators to work well outside of their comfort zone.

A poster outlining the ground rules for a PAG in Quezon City.

A poster outlining the ground rules for a PAG in Quezon City.

Another challenge has been learning how best to support the participants, some of whom are going through very difficult life circumstances related to disability, family relationships and in some circumstances, experience of violence and abuse. This is also where the importance of the PAG coordinator and the broader W-DARE team has been critical. Despite these challenges, the facilitators spoke not only of increased confidence and knowledge of SRH, but also that the PAG process has helped them to develop strategies for coping with stress which has also had a positive effect on their relationships.

Each session requires meticulous logistics and careful navigation through windy and narrow Barangay roads, as well as the support of families in helping participants attend the session, either through taking care of children whilst their mothers attend the session, or making the sometimes long journey to the session with the women. Whilst visiting Ligao City, we made a visit to the homes of a few of our participants to talk with them about how they are finding being involved in the PAGs. The women we spoke with were all very positive about their PAG experience, particularly about the opportunity to come together with other women that the PAG sessions provide. One family had returned early from their holiday so their daughter could attend the PAG session the following day. Knowledge learnt in the PAG sessions has also supported women to access services, not only in terms of SRH, but also in terms of services to support their other needs, such as access to knowledge on available services such as assistive devices and social protection.

Ligao City PAG facilitators and participants, W-DARE PAG Coordinator Rag Ignacio and Liz Gill-Atkinson, a W-DARE team member from the University of Melbourne.

Ligao City PAG facilitators and participants, W-DARE PAG Coordinator Rag Ignacio and Liz Gill-Atkinson, a W-DARE team member from the University of Melbourne.

It will be great to follow the PAG journey over the coming months and see where each group takes their acquired knowledge and new social networks, and what each woman can do to continue to promote their own SRH, and collectively what they can do to promote the SRH of other women with disability in the Philippines.

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